Individual provider Active NPI

Lynn Ellen Reordan, P.T.

  • Physical Therapist
  • Jacksonville, OR
National Provider Identifier
1518135334
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03337 Issued in OR
Practice address
635 N. 5TH St.
Jacksonville, OR 97530
Phone
(541) 899-8179
Fax
(541) 899-0244
NPI assigned
Feb 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4337 OR
Physical Therapist 225100000X 03337 OR Primary

Addresses

Primary practice location

635 N. 5TH St.
Jacksonville, OR 97530

Mailing address

635 N. 5TH St.
Jacksonville, OR 97530
Phone (541) 899-8179

Other names 1

  • Ms. Lynn Ellen Evans Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000244 OR Practitioner - Physical Therapist in Private Practice 0446334338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reordan Physcial Therapy, IncGroup PAC ID 1456435346, 4 clinicians

Practice addresses (Care Compare)

635 N 5TH St
Jacksonville, OR 97530-9659
Phone (541) 899-8179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03337ORMDPhysical Therapist
4337ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reordan Physcial Therapy, Inc CurrentSince Jan 1, 2008 Accepting new patients

Locations

1208 Beall Ln
Central Point, OR 97502

635 N 5th St
Jacksonville, OR 97530
Phone (541) 889-8179

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1518135334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N. 5TH ST.",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "97530",
            "telephone_number": "541-899-8179",
            "fax_number": "541-899-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N. 5TH ST.",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "97530",
            "telephone_number": "541-899-8179",
            "fax_number": "541-899-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REORDAN",
        "first_name": "LYNN",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4337",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "03337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "EVANS",
            "middle_name": "ELLEN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.